目的:通过临床药师对1例患有多种基础疾病患者个体化治疗方案的设计和实施,体现药师在临床住院患者治疗中的作用。方法:针对具体病例,临床药师运用所学知识和经验,并依循证医学证据,参与药物治疗方案的制定并实施,为临床药物治疗提供参考。结果:通过临床药师参与药物治疗方案的修订,可提高临床药物治疗效果并减少用药风险。结论:临床药师针对患者开展个体化的药学服务,可为医、患双方提供安全、高效的用药方案。 OBJECTIVE: To demonstrate the role of pharmacists in the treatment of clinical inpatients through the design and implementation of clinical pharmacists’ individualized treatment regimens for a single patient with multiple underlying diseases. Methods: According to the specific cases, clinical pharmacists use the knowledge and experience, and follow the evidence of evidence to participate in the formulation and implementation of drug treatment programs, to provide a reference for clinical drug treatment. Results: The revision of pharmacotherapy programs by clinical pharmacists can improve the efficacy of clinical drug treatment and reduce the risk of medication. Conclusion: The clinical pharmacist carries out individualized pharmacy services for patients and can provide safe and efficient medication regimens for both doctors and patients.